It’s Time to Talk about Molly

I was at a New Year’s Eve party in a warehouse in Bushwick when I saw a man almost die.

This was the late-late crowd: those who had long since finished with champagne toasts and rooftop cocktails; who soared through the toll of 2 a.m. and plunged into a body-quaking, deep-night dance floor odyssey; who shook their sweat out to a steady, cavernous beat that pulsed from a colossal panorama of monitors; who sprawled across mattresses and heaps of stuffed animals and took naps with strangers; who tranced with glazed gazes under LED-induced spells; who climbed atop art cars and swung from spiral staircases; who meditated back-to-back in crawl spaces; who licked and snorted and swallowed their drugs of choice in the bathrooms; who hugged their friends and lovers like the sun wouldn’t rise; and when it did, who greeted the morning light with hands high and kept the party going.

It was around 10 a.m. when it happened. Colored panels on the warehouse windows filtered the morning sun so it cast a spectrum of shadows across the room. Somewhere in the rafters, a fog machine released billows of vapors that nimbused the lights and settled on the dance floor. Over the deep drone of bass I heard someone scream, and a circle opened in the crowd to my right. A man lay on the concrete at its center, his body convulsing violently.

Several people rushed forward at once. One took his head in her lap and shoved a glove between his teeth. The others attempted to keep his limbs from striking out in all directions while he seized.

I looked at his face — eyes rolled back into trembling white slivers, jaw crooked and quivering — and saw that he couldn’t have been much older than myself.

His friends ran to get water from the bar and party organizers called 911. Within minutes, he was foaming at the mouth, and despite the best efforts of those who held him, he stopped breathing altogether. The seizure lapsed into unconsciousness, and we were helpless to do anything but look on as his caretakers attempted to resuscitate him.

When he wouldn’t respond to chest compressions, or to slaps on the face, or to the screams of his friends, the search for his pulse began in earnest. Meanwhile, hundreds of people danced on all around us, unaware that someone was slowly vacating his senses in their midst.

“Don’t look,” the person standing next to me said. “He’s going. You don’t want to see someone die.”

And he was right: that man was going to die right there in front of us. It struck me with sickening certainty that it could just as easily be me or one of my friends on the floor, gnashing and lightning-racked and chemically catapulted into paroxysms. I couldn’t walk away.

Just as the paramedics finally arrived, the man’s eyelids began to flutter. The last I saw of him, he was strapped to a gurney headed for the rear exit. He looked lost and bleary, but alive.

I asked one of his friends what he had taken that night. Her answer was simple: “Just Molly.”

So let’s talk about Molly, the raver’s drug that in recent years has experienced a booming renaissance and reemerged in our cultural consciousness.

In theory, Molly is the purer form of Ecstasy, the club-scene darling of the 90s. Most users believe that because it comes in a crystalline powder rather than an ambiguous cartoon-branded pill, the drug is closer to the unadulterated root of 3,4-methylenedioxymethamphetamine, or MDMA.

In reality, recreational Molly is often cut with a cocktail of chemical compounds (caffeine, ketamine, speed, codeine, and bath salts, to name a few) which can lead to serious adverse reactions or fatalities. The danger lies in the fact that these substances behave similarly to MDMA by releasing serotonin, dopamine, or norepinephrine in the brain, but that their dosages operate differently. Unscrupulous dealers don’t take this disparity into account when cutting adulterants into batches of what then goes to market as Molly.

“Just the slightest increase in one of these more potent analogues can mean the difference between a ‘great high’ and cardiac arrest,” said Dr. Mark Neavyn, director of medical toxicology at Hartford Hospital, in an interview with Newsweek.

Yet the vast majority of recreational Molly is not pure, or even close to pure. Only 13 percent of the Molly seized by the Drug Enforcement Administration between 2009 and 2013 tested positive for any MDMA at all. According to the Drug Abuse Warning Network, MDMA-related emergency room visits have doubled since 2004. Many of these traumas resulted not from actual MDMA, but from a combination of uncontrolled substances that people ingested unintentionally.

“When we check the urine of people who say they took Ecstasy or Molly,” details Frank LoVecchio, Director of the Banner Poison and Drug Information Center, “most of them just turn up with methamphetamines.”

In LoVecchio’s 20 years directing Banner, he has found that methamphetamines actually test more commonly than true MDMA in Molly-related emergency cases.

“It’s astonishing when we ask kids if they would ever do meth and they say ‘Of course not,'” he tells BTRtoday. “And we have to tell them that their bodies are full of meth. They’re always amazed to find that out.”

Of course, no drug is 100 percent safe to take, and MDMA is no exception. LoVecchio warns that overdoses, although rare, can lead to high blood pressure, fast heart rate, hyperthermia (dangerously high body temperatures), and hyponatremia (dangerously low sodium levels). In safe doses and in pure form, however, MDMA floods the brain with serotonin and induces a physically and emotionally rapturous state in which users experience drastically increased empathy and decreased fear or defensiveness. Its ability to promote feelings of trust and bonding led psychotherapists to give it to patients in sessions before the Food and Drug Administration (FDA) banned the drug in 1985.

“The most profound effect of MDMA’s illegality has been curtailing of scientific research of a drug that held therapeutic potential,” says Dana Blu Cohen, Psy.D.

Cohen worked as a research assistant with the Multidisciplinary Association of Psychedelic Studies (MAPS), a nonprofit research organization that seeks to explore the benefits of MDMA-assisted psychotherapy in patients with chronic post-traumatic stress disorder (PTSD).

PTSD, while usually associated with war veterans, is a debilitating malady that can also wreak havoc on the lives of survivors of rape, harrowing accidents, violent crime, and childhood sexual abuse. Treatment for the condition is difficult, however, because each individual psychologically stores and physiologically manifests his or her trauma differently.

In conjunction with psychotherapy, doctors generally prescribe selective serotonin reuptake inhibitors (SSRIs) like Zoloft or Paxil to ameliorate the biological symptoms of PTSD. Like MDMA, SSRIs block receptors in the brain that reabsorb serotonin, therefore causing an excess of the neurotransmitter and amplifying its effects.

But many people who suffer from the condition do not respond to SSRIs, which Cohen says “do little to address the complex cluster of symptoms” wrought by PTSD.

MAPS has therefore undertaken a nearly $20 million plan to push the FDA towards approving MDMA as a prescription medication by 2021.

Unlike other medications for PTSD, which must be taken daily ad infinitum, MDMA is only administered several times throughout treatment. And while the drugs purporting to contain MDMA in recreational markets are contaminated with harmful toxins, MAPS uses moderate doses of government-sanctioned 99.9 percent pure MDMA in its trials. These trials, it should be noted, are double- or sometimes triple-blind, so that neither the therapist nor the patient knows which dose has been administered.

Patients receive the drug in two separate eight-hour sessions, during which time they are encouraged to discuss their most painful memories and fears with the supervising therapist. The sense of trust and elation promoted by the MDMA often enables them to engage with these experiences in deeply personal ways they would not be able to otherwise. Sessions in which drugs are administered are separated by weeks of non-drug psychotherapy sessions.

So far, results have been astounding.

All subjects of a recent MAPS study reported persisting benefits from the MDMA-assisted therapy, and after a two-month follow-up, 83 percent of participants were no longer diagnosed with PTSD.

“It can be argued that given the possibilities offered by MDMA in conjunction with treatment,” Cohen explains, “not furthering the cause of descheduling in order to make MDMA accessible to those with treatment-resistant PTSD–often survivors of the injustices of childhood abuse, rape, and war — is to turn a blind eye to human suffering.”

In her opinion, MDMA-assisted psychotherapy represents the future and evolution of the helping profession.

MAPS continues to overcome scientific and regulatory barriers that preclude researchers from working with highly stigmatized substances.

And unfortunately, as long as MDMA remains criminalized, dangerously convoluted analogues will continue to saturate the recreational market and put indiscriminate or indifferent party-goers at risk. If the flourishing industries for alcohol, cigarettes, and fast food are any indication, people will continue to consume something even though they understand that it may not be good for them.

“I’d be a fool to think that people are going to stop doing drugs,” admits LoVecchio. “The demand will be there.”

So, what to do about Molly, which continues to grow in popularity but decrease in reliability?

Proceed with caution.

“I’d be very, very careful about putting a pill in my mouth,” warns LoVecchio.

It’s great that your friend may trust his dealer, and you may really trust your friend, but the honest truth is that the substances you put in your body pass through enough hands that you can’t say with certainty that they are entirely safe. And when it comes to drug use, safe is always — always — better than sorry.